Fri Feb 17 2023

95 articles - From Friday Feb 10 2023 to Friday Feb 17 2023

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Guidelines

Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…

Gastroenterology

AGA Clinical Practice Update on Telemedicine in Gastroenterology: Commentary.

Methods This CPU was commissioned and approved by the AGA Institute Clinical Practice Updates Committee (CPUC) and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership and underwent internal peer review by the CPUC and external peer review through standard procedures of Gastroenterology. This expert commentary incorporates important, as well as recently published, studies in this field, and it reflects the experiences of the authors who are active gastroenterologists and hepatologists with extensive experience using telemedicine in clinical practice.

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Gastrointest Endosc

American Society for Gastrointestinal Endoscopy guideline on management of post-liver transplant biliary strictures: methodology and review of evidence.

In patients with unclear diagnosis or intermediate probability of a stricture, we suggest MRCP as the diagnostic modality. We suggest that antibiotics should be administered during ERCP when biliary drainage cannot be assured.

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American Society for Gastrointestinal Endoscopy guideline on management of post-liver transplant biliary strictures: summary and recommendations.

In patients with unclear diagnoses or intermediate probability of a stricture, we suggest MRCP as the diagnostic modality. We suggest that antibiotics should be administered during ERCP when biliary drainage cannot be ensured.

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Framework and metrics for the clinical use and implementation of artificial intelligence algorithms into endoscopy practice: recommendations from the American Society for Gastrointestinal Endoscopy Artificial Intelligence Task Force.

We also provide guidance and best practices for evaluation of AI technologies as they mature in the endoscopy space. Note, this is a living document; periodic updates will be published as progress is made and applications evolve in the field of AI in endoscopy.

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Meta-analysis

meta-analyses and systematic reviews

Am J Gastroenterol

Patients with Crohn's disease and permanent ileostomy are universally excluded from clinical trials: A systematic review.

There is an urgent need to identify barriers to enrollment and develop eligibility and outcome measures enabling the inclusion of patients with CD and PI into clinical trials.

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Neurogastroenterol Motil

Volatile organic compounds as potential biomarkers of irritable bowel syndrome: A systematic review.

Combining VOC into panels allowed the creation of discriminative algorithms. Though current research is limited by areas of heterogeneity in VOC sampling and small sample sizes, our review shows that VOC analysis has the potential to be a noninvasive point-of-care test that differentiates IBS from other organic gastrointestinal diseases.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

Risk of severe and opportunistic infections and the impact of SARS-COV-2 on this risk in a nationwide cohort of patients with inflammatory bowel disease.

In a nationwide cohort of IBD patients, we found that risk of serious infections could possibly be affected by behavioural modifications due to SARS-COV-2 pandemic.

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Am J Gastroenterol

Diagnosis and management of cyclic vomiting syndrome: A critical review.

Treatment of comorbid conditions is extremely important to improve overall patient outcomes. CVS has a significant negative impact on patients, families, and the healthcare system and future research to understand its pathophysiology and develop targeted therapies is needed.

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Incidence of cirrhosis among recent immigrants and refugees to Ontario, Canada.

N=25,054 immigrants/refugees were identified with rates of cirrhosis lower compared to Canadian/long-term residents for al etiologies expect HBV likely explained by the health immigrant effect. NAFLD was the most common etiology of cirrhosis among immigrants and refugees.

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Clin Gastroenterol Hepatol

Clinical Outcomes of Intraductal Papillary Mucinous Neoplasms With Dilatation of the Main Pancreatic Duct.

IPMNs with MPD dilatation at baseline were associated with higher prevalence and incidence of pancreatic carcinoma compared to IPMNs with no MPD dilatation.

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Epidemiology of gastric malignancies 2000-2018 according to histology: a population-based analysis of incidence and temporal trends.

GA was the most common histology. Based on our findings, the rise in noncardia GC among certain US populations appears predominantly driven by NET and GIST, not GA. Further studies are needed to clarify underlying etiologies for these findings.

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Preclinical Serological Signatures are Associated with Complicated Crohn's Disease Phenotype at Diagnosis.

Proteins and anti-microbial antibodies associated with dysregulated innate immunity, excessive adaptive response to microbial antigens, and fibrosis, precede and predict a complicated phenotype at the time of diagnosis in CD patients.

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Racial and Ethnic Disparities in Characteristics and Care Patterns of Chronic Hepatitis B Patients in the United States.

Compared to Asian CHB patients, non-Asian patients were less likely to undergo adequate evaluation and Hispanic patients less likely to receive treatment for CHB. Additional efforts are needed to improve CHB management, especially for non-Asian patients.

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Second Line Biologic Therapy Following Tumor Necrosis Factor Antagonist Failure: A Real World Propensity Score Weighted Analysis.

In two independent real-world setting cohorts, second line therapy in CD with ustekinumab after TNF antagonist treatment failure was associated with lower likelihood of treatment failure than second line vedolizumab.

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The surface morphology of large non pedunculated colonic polyps predicts synchronous large lesions.

6.9% of LNPCPs have synchronous disease with NG-LNPCPs demonstrating a greater than fourfold increased risk. With post-colonoscopy interval cancers exceeding 5%, endoscopists must be cognisant of an individual's LNPCP phenotype when examining the colon at both index procedure and surveillance.

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Endoscopy

Artificial Intelligence for diagnosing neoplasia on digital cholangioscopy: development and multicentric validation of a convolutional neural network model.

The proposed CNN models distinguish neoplastic bile duct lesions with good accuracy and outperformed two nonexperts and one expert endoscopists.

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No-touch endoscopic full-thickness resection technique for gastric gastrointestinal stromal tumors.

CONCLUSIONS : NT-EFTR was a feasible method for the resection of gastric GISTs and can be expected to achieve complete radical resection. Large tumors with extraluminal growth and large gastric defects impact procedural difficulty.

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Gastroenterology

Increasing Pancreatic Cancer Incidence in Young Women in the US: A Population-Based Time-Trend Analysis, 2001-2018.

Methods PC aIR, mortality rates, annual percentage change (APC), and average APC (AAPC) were calculated and assessed for parallelism and identicalness. Age-specific analyses were conducted in older (=55 years) and younger ( 200% difference), and it did not show slowing down.

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M6A-mediated upregulation of FZD10 regulates liver cancer stem cells properties and lenvatinib resistance through WNT/ß-catenin and Hippo signaling pathways.

Elevated FZD10 expression promotes liver CSCs expansion and lenvatinib resistance, indicating that FZD10 expression is a novel prognostic biomarker and therapeutic target for human HCC.

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PNPLA3 genotype and diabetes identify patients with non-alcoholic fatty liver disease at high risk of incident cirrhosis.

PNPLA3-rs738409 genotype and diabetes identified patients with NAFLD currently considered indeterminate risk (FIB4 1.3-2.67) who had similar risk of cirrhosis as those considered high-risk (FIB4 2.67). PNPLA3 genotyping may improve prognostication and allow for prioritization of intensive intervention.

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TET1 and TDG suppress inflammatory response in intestinal tumorigenesis: implications for colorectal tumors with the CpG Island Methylator Phenotype.

Our findings reveal a novel epigenetic regulation, linked to the type of genomic instability, by which TET1-TDG-mediated DNA demethylation decreases methylation levels and inflammatory/interferon/immune responses. CIMP in CRC is triggered by an imbalance of methylating activities over demethylating activities. These mice represent a model of CIMP CRC.

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Gastrointest Endosc

Automated Electronic Health Record-Based Application for Sedation Triage in Routine Colonoscopy.

The EHR-based application, which automates and standardizes determination of sedation type, is a highly beneficial tool that eliminates subjectivity in decision-making, thus allowing for appropriate use of MAC. Complication rates and sedation failure did not increase with use of the application. With the increase in use of MS over MAC, health care costs for the more expensive MAC sedation should also decrease.

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Clinical evaluation of a novel drill dilator as the first-line tract dilation technique during EUS-guided biliary drainage by non-expert hands (with video).

The novel drill dilator might be useful as a dilation device, however, the balloon dilation technique should be selected first upon deploying a dedicated metal stent with an 8.5Fr stent delivery system.

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Innovative method for the diagnosis of bile duct lesions using a novel tapered-tip sheath system to facilitate biliary biopsies.

The novel tapered-tip sheath system is a promising tool for biliary stricture diagnosis.

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Gut

Acetyltransferase from Akkermansia muciniphila blunts colorectal tumourigenesis by reprogramming tumour microenvironment.

Amuc_2172 reprogrammed tumour microenvironment by inducing HSP70 secretion and promoting CTL-related immune response in the process of tumourigenesis.

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Gut virome-colonising Orthohepadnavirus genus is associated with ulcerative colitis pathogenesis and induces intestinal inflammation in vivo.

This study described HBx as a contributor to the UC pathogenesis and provides a new perspective on the virome as a target for tailored treatments.

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IL-17A-producing CD8+ T cells promote PDAC via induction of inflammatory cancer-associated fibroblasts.

We identified Tc17 as a novel protumourigenic CD8 + T-cell subtype in PDAC, which accelerated tumour growth via IL-17RA-dependent stroma modification. We described a crosstalk between three cell types, Tc17, fibroblasts and tumour cells, promoting PDAC progression, which resulted in poor prognosis for patients.

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Immune response and barrier dysfunction-related proteomic signatures in preclinical phase of Crohn's disease highlight earliest events of pathogenesis.

We identified serum proteomic signatures associated with future CD development, reflecting potential early biological processes of immune and barrier dysfunction.

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Spatially restricted tumour-associated and host-associated immune drivers correlate with the recurrence sites of pancreatic cancer.

Our findings demonstrate distinct inflammatory/stromal responses in each recurrence group, which might affect dissemination patterns and patient outcomes. These findings may help to inform personalised adjuvant/neoadjuvant and surveillance strategies in PDAC, including immunotherapeutic modalities.

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Sympathetic nervous activation, mitochondrial dysfunction and outcome in acutely decompensated cirrhosis: the metabolomic prognostic models (CLIF-C MET).

Models including metabolites (CLIF-C MET) reflecting SI, mitochondrial dysfunction and sympathetic system activation are better predictors of short-term mortality than scores based only on organ dysfunction (eg, MELDNa), especially in patients with ACLF.

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Hepatology

Aberrant fucosylation sustains the NOTCH and EGFR/NF-kB pathways and has a prognostic value in human intrahepatic cholangiocarcinoma.

Elevated global fucosylation characterizes human iCCA, contributing to cell growth and migration via the upregulation of the NOTCH and EGFR/NF-kB pathways. Thus, aberrant fucosylation is a novel pathogenetic player and a potential therapeutic target for human iCCA.

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Neurogastroenterol Motil

Anxiety correlates with excessive air swallowing and PPI refractoriness in patients with concomitant symptoms of GERD and functional dyspepsia.

Our results, if confirmed in in a larger, prospective clinical and therapeutic study, demonstrate the usefulness of an up-front evaluation with anxiety questionnaire and esophageal testing in patients with a broad spectrum of upper gastrointestinal symptoms who fail to respond to PPI treatment, supporting the option of alternative treatment modalities.

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Exploration of associations among dietary tryptophan, microbiome composition and function, and symptom severity in irritable bowel syndrome.

Dietary TRP intake, microbiome composition, and differences in TRP metabolism constitute a complex interplay of factors that could modulate IBS symptom severity.

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On-therapy impedance-pH monitoring can efficiently characterize PPI-refractory GERD and support treatment escalation.

We have defined on-PPI cut-offs of impedance-pH metrics by which comprehensive assessment of impedance-pH tracings, including analysis of PSPW index and MNBI can efficiently characterize PPI-refractory GERD and support treatment escalation.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Aliment Pharmacol Ther

Editorial: achievements and unresolved questions in improving the pharmacokinetics of vedolizumab in adolescents with inflammatory bowel disease.

Pubmed   Journal   ReadQx 

Editorial: baseline hepatitis B virus haplotype number may help predict a functional cure in patients with chronic hepatitis B treated with nucleotide analogues.

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Editorial: considerations for expanding treatment in grey zone chronic hepatitis B patients.

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Editorial: faecal microbiota transplantation for recurrent C. difficile infections-getting the support that is needed.

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Editorial: treat-to-target in ulcerative colitis clinical management-a small price to pay?

Pubmed   Journal   ReadQx 

Gastroenterology

Genetically Engineered Mouse Models Shine New Light on Decades-old Story of Trypsin in Pancreatitis.

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Gut

Clinical advances: pregnancy in gastroenterologic and hepatic conditions.

To be able to provide the best possible care to these patients, gastroenterologists need to be aware of (and familiar with) the various nuances and caveats related to the care of pregnant patients who either have underlying gastrointestinal (GI) conditions or present with GI and liver disorders. Here, we offer a clinical update with references more recent than 2018, along with a few words about SARS-CoV-2 infection and its relevance to pregnancy.

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J Hepatol

Current Treatment Strategies and Future Possibilities for Sarcopenia in Cirrhosis.

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Mouse models of hepatocyte biology - known unknowns.

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Nursing Care For Patients With Cirrhosis.

In the primary care setting, nurses should play an important role in the care of patients with compensated cirrhosis and also facilitate early diagnosis of cirrhosis in subjects at risk of liver diseases. This review calls for an improved global liver diseases education program for nurses and increased awareness among al healthcare providers and policy makers of the positive impacts of advanced or specialist nursing practice in this domain.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Am J Gastroenterol

Combined antero-retrograde endoscopic rendezvous approach for placing a colonic stent in a short bowel syndrome.

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Spontaneous fistulization of Walled-Off Pancreatic Necrosis into the Stomach.

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Taking a "Second Look" at the Incidence of Pediatric Celiac Disease.

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Clin Gastroenterol Hepatol

Endoscopic removal and typical presentation of biliary cast formation.

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Sodium-Glucose Cotransporter-2 Inhibitors and Risk of Hepatocellular Carcinoma Among Patients with Type 2 Diabetes.

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Endoscopy

"Snare-pulley" clip-with-line technique to prevent polyp migration after endoscopic resection of a polyp in the third portion of the duodenum.

Pubmed   Journal   ReadQx   PMC

A novel salvage method to recapture the maldeployed distal flange of a lumen-apposing metal stent.

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A simple endoscopic full-thickness plication procedure for the treatment of gastroesophageal reflux disease.

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Candy cane syndrome: a new endoscopic treatment for this underappreciated surgical complication.

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Clip and dental floss traction-assisted endoscopic mucosal resection for early carcinoma of the duodenal papilla.

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Endoscopic hemostasis of spurting colonic diverticular bleeding using the combination of self-assembling peptide solution and endoscopic band ligation.

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Endoscopic intermuscular dissection of rectal T1 cancer with adaptive traction: use of additional loops to improve traction directly on the circular muscular layer.

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Endoscopic management of a migrated biliary stent in the pleura: a rare complication.

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Endoscopic resection of a huge Vanek's tumor (inflammatory fibroid polyp).

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Laparoscopic and endoscopic combined surgery to treat a large superficial nonampullary duodenal tumor.

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Linear array endoscopic ultrasonography for a patient with situs inversus totalis.

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Modified technique for deployment of a lumen-apposing metal stent during endoscopic ultrasound-guided choledochoduodenostomy in minimally dilated duct.

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Novel clip-traction band device-assisted endoscopic submucosal dissection for superficial pharyngeal carcinoma.

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Radiation-free digital cholangioscopy-guided removal of bile duct foreign body and holmium laser lithotripsy for large common bile duct stones.

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Ruptured cystic artery pseudoaneurysm after long-term transpapillary placement of a gallbladder stent for acute cholecystitis.

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Spigelman IV: can intensive cold snaring avoid duodenectomy in familial adenomatous polyposis?

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Successful omental patch for huge colonic perforation using regraspable clip.

Pubmed   Journal   ReadQx   PMC

Treating delayed perforation after esophageal endoscopic submucosal dissection using polyglycolic acid sheets and fibrin glue.

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Underwater clipping in the colon.

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Underwater endoscopic mucosal resection aided by a protruding anchor created by saline injection into the distal duodenal fold.

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Gastroenterology

AMERICAN GASTROENTEROLOGICAL ASSOCIATION (AGA) MEMBERSHIP POLICY PRORITIES - BUILDING THE AGA ADVOCACY AGENDA.

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Looking for a needle in a haystack.

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Obeying the Law: Energy balance in alternate day fasting, exercise, or both together in patients with obesity and NAFLD.

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Gastrointest Endosc

Cholangioscopy inspection immediately after endoscopic retrograde cholangiopancreatography for large common bile duct stone might be beneficial to discover potential cholangiocarcinoma resulting from choledocholithiasis.

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Endoscopic submucosal dissection of a rare cardiac mass in an older women: dendritic fibromyxolipoma.

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EUS guided gastroenterostomy to relieve biliary obstruction due to afferent limb syndrome in complex post-surgical anatomy.

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Overcoming the Challenge of Per-Oral Endoscopic Myotomy in a Type 3 Achalasia Corkscrew Esophagus.

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Gut

Parabacteroides distasonis: an emerging probiotic?

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MicroRNA-223: a key regulator of liver tumour microenvironment.

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More than meets the eye: a strange cause of bowel obstruction and perforation.

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Letters&Replies

Letters to the editors and authors’ replies

Aliment Pharmacol Ther

Editorial: achievements and unresolved questions in improving the pharmacokinetics of vedolizumab in adolescents with inflammatory bowel disease-authors' reply.

Pubmed   Journal   ReadQx 

Editorial: baseline hepatitis B virus haplotype number may help predict a functional cure in patients with chronic hepatitis B treated with nucleotide analogues-authors' reply.

Pubmed   Journal   ReadQx 

Editorial: considerations for expanding treatment in grey zone chronic hepatitis B patients-authors' reply.

Pubmed   Journal   ReadQx 

Editorial: IBD and sleep-authors' reply.

Pubmed   Journal   ReadQx 

Editorial: inflammatory bowel disease and sleep.

Pubmed   Journal   ReadQx 

Editorial: treat-to-target in ulcerative colitis clinical management-a small price to pay? Authors' reply.

Pubmed   Journal   ReadQx 

Letter: improved alanine aminotransferase level in non-cirrhotic and low-viral load chronic hepatitis B patients treated with nucleotide/nucleoside analogues -authors' reply.

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Letter: improved alanine aminotransferase level in patients with chronic hepatitis B without cirrhosis and low viral load treated with nucleotide/nucleoside analogues.

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Letter: sleep duration and the incidence of inflammatory bowel disease.

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Letter: the diagnostic value of ultrasound-based versus CT-based sarcopenia measurement in cirrhosis - authors' reply.

Pubmed   Journal   ReadQx 

Letter: the diagnostic value of ultrasound-based versus CT-based sarcopenia measurement in cirrhosis.

Pubmed   Journal   ReadQx 

Clin Gastroenterol Hepatol

Mechanical Lithotripsy for Large Common Bile Duct Stones: Out of Practice or Just Out of Fashion?

Pubmed   Journal   ReadQx 

Nonalcoholic Steatohepatitis Decompensation and Portal Pressures.

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Gut

Considerations for peripheral blood transport and storage during large-scale multicentre metabolome research.

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Right tool for the right bleeder.

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J Hepatol

Fairness Metrics: Additional Principles to Consider for Improving MELD.

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